Update on me....for those who are interested.

Oh gee.  This could be from certain meds or from uncontrolled blood sugar.  Or what?  What meds are you taking that have to be monitored for kidney problems?

I'm sorry to hear you are going through that Jim. Keep your chin up and keep us posted here.

sending healing thoughts your way jim. jamie

Had the appointment today. With the exception of the elevated protein levels in the urine everything else looks fine.

I was told to continue with the Lisinopril and to "get my blood sugars under control".

That last part kind of ticks me off as if I don't know after 12 years what having chronic high BGLs can do to a person and it isn't like I haven't been trying for years to do just that.

I realize that he doesn't know me, doesn't know my overall history or anything like that, but it still strikes a nerve considering all of the problems I have had with the medical community in regards to my blood sugars.

What really had me ready to smack him was when he said "Maybe when you see this new endo in November you can find out what you have been doing wrong."

It is that attitude, whether spoken or not, has really been at the crux of the problem and what I feel is really behind why I have never been able to control my BGL for more than a few days or weeks at a time. In the beginning, OK, fine I made some errors, had a lot to learn, etc, but after 12 years I probably know more about diabetes, diet, foods, etc than he does. Regardless if I do or don't though it is the assumption that I am at fault that just really irritates me.

Come on, will you. The last record sheet I turned in to the last endo was 6 weeks worth of 4x daily reading, complete with meal carb counts, daily avgs for carbs and BGL's and also I did a monthly avg for both. Daily avg carbs count for the 6 week period was 22g and the daily avg BGL was 296, and this was on 50u per meal of fast and 200 u daily of basil insulins. My A1C's in the past 18 months have went from 11.7 (which was having not taken any meds at all for nearly a year) to 12.9 while my insulin use went from 15u/meal and 35/u daily basil to the 50/meal and 200/basil. Now between all of that data something should say...something is wrong here.

Of course that last endo I saw answer to all of this was to have the nurse call my house 2 hours before my last appointment and say if I couldn't make it in within 30 minutes I would have to reschedule and the 1st available appointment was 4 months away. Now what does that say tell you about the kind of idiot I was having to deal with? (Rhetorical question).

Sorry. It all is just such a touchy subject for me. This has been the basic story since I was dx with diabetes. None of the doctors I have seen want to listen to what I have to say. They don't want to believe the data I provide them, and it just isn't the local ones either. I have been to the Mayo Clinic because of this and got the same BS. 5 or so years into it I was sent up there and was treated like I had been Dx'd a week before. Was sent through all the basic courses with the educators, dietitians, etc.

I don't know much about anything, I don't even remember did I ask this from you already. Have they not taken the lab test to see whether you are insulin resistant or not? Mine came back at 39, don't know what the units are, but it should be between 1-10. My doctor ordered that test after seeing my insulin intake creeping up over the years. I kept hitting the limits of the recipes she wrote and had to pay the full non-subsidized price from time to time..

I'm injecting about twice as much as other type 1's, but this is required to keep BGL in some level of control. However, I'm also eating 7 times as much carbs as you are per day, and you are still injecting about 3 times as much as I am. Your situation seems like any amount you inject had very little effect to your blood glucose and I have no idea can that be explained by just insulin resistance. I might also assume that there are other kinds of insulins that you might try, but I don't know would it make a difference. I know that the current long acting insulin I'm on works in a different way than the mix I used to take before, and it even affects the fast acting insulin, making me inject even more of that per meal.

Jim, out of curiousity, how many carbs do you eat a day or at a meal?

That is the strangest thing, that the two months on a zero-carb diet didn't affect the blood sugar and no real difference when you didn't worry about carbs.  Something screwy here....

Jim, Have you checked into what they call "LADA"? Apparently, there is a type of adult onset diabetes that is really more like juvenile diabetes, or Type I. For some reason, I believe Type I and Type II react differently to insulin because Type I is actually an "autoimmune disorder". I am not certain if it would make a difference in your case, but it might be worth some looking into. LADA is L-atent A-utoimmune D-isorder in A-dults, and some go as far as labelling it Type 1.5 Diabetes.
Here is a link for some information:

http://diabetes.diabetesjournals.org/content/54/suppl_2/S62.full

"Is Latent Autoimmune Diabetes in Adults Distinct From Type 1 Diabetes or Just Type 1 Diabetes at an Older Age?"

I have autoimmune disorders, and find this to be interesting, although, I haven't been keeping an eye on any new information for a while.
Hope maybe this will help. Keep us posted.
And, just an FYI for what it's worth, I eat every three hours, and I alternate ONLY complex carbs and then protein. I have been able to control with this regimen without taking meds. So, complex carbs at 9, protein at 12, complex carbs at 3, and protein at 6. Please remember that men require more protein than women because you are more muscular design, and your muscle structure requires more. I believe men need at LEAST 60 grams of protein daily, while women can get by with only about 55 grams. After my evening meal, I fast till bedtime, and at bedtime I do protein. So far so good, and my doctor says that as long as I maintain control, the disease will not progress. I have severe painful neuropathy from a serious neck injury, but the doctor tells me I will KNOW if I develop diabetic neuropathy.

Have you ever had the C-peptide test?  It can measure how much insulin, if any, is still produced in your body.   This is from www.labtestsonline.org:

"C-peptide measurements can also be used in conjunction with insulin and glucose levels to help diagnose the cause of documented hypoglycemia and to monitor its treatment. Symptoms of hypoglycemia may be caused by excessive supplementation of insulin, alcohol consumption, inherited liver enzyme deficiencies, liver or kidney disease, or by insulinomas. Insulinomas are tumors of the islet cells in the pancreas that can produce uncontrolled amounts of insulin and C-peptide and can cause acute episodes of hypoglycemia. C-peptide tests may be ordered periodically to monitor the effectiveness of insulinoma treatment and to detect recurrence.

Sometimes a C-peptide test may be used to help evaluate a person diagnosed with metabolic syndrome, a set of risk factors that includes abdominal obesity, increased blood glucose and/or insulin resistance, dyslipidemia, and hypertension."

Folks, like I have mentioned many times I can't get these quacks to check anything. The only lab tests they want to do are basic ones like A1C, cholesterol, and the occasional urine test to check for protein.

They won't even discuss any potential contributing factors.

Right now all I can do is wait until November and see what this next endo is going to do. I am rapidly running out of doctors in my little corner of the world and with gas prices like they are, not to mention being the primary care provider of a 6 year old I do not have the time or money to be traveling 60 or more miles one way to try to find another doctor.

I don't know if I ever mentioned it on this forum or not but I have been essentially blacklisted among most doctors in my immediate area. We no longer have any real independent practices where I live. They are all associated heavily with if not directly employed by the county hospital or they are part of a clinic run by a hospital 60 miles away. I was black listed by a doctor with the former for missing appointments which was due to opioid induced memory loss. Even after explaining what was going on it made no difference and it took me almost a year to find a doctor who would take me as a patient due to the black listing and also the lack of doctors in this area. With the exception of a few new doctors most PCP's are running at well over 100% patient capacity.

So far the only 2 medical professionals who believe as I do that something is going on that is screwing me up big time are 2 of my wife's nursing instructors. They have tried to help by giving things to look for, things to talk to my doctors about etc, but that is the limit of what they can do.

Oh and to add injury to insult I am now without a meter thanks to the state. (Yes I am currently on Medicaid) The discontinued paying for testing supplies for all meters except 2. One of which I can't use due to the way the testing strips are and because of a loss of motor control in my dominant hand and the other no one carries around here. In a few weeks I am going to buy one from Wal Mart, but I am only going to be afford to purchase 50 strips a month.